1
Flood in Shkodra
Shkodra is located in north-western Albania. It has a surface of 1302.96km², divided administratively into two municipalities: Shkodra and Vau Dejes, 15 municipalities, 138 Villages and 2 cities. Three rivers surrounding the city of Shkodra: Buna, Drini and Kiri. In the northwest of it is located Shkodra Lake. The geographic coordinates are: latitude 19 degrees 30’ 42”, longitude 45 degrees 03’ 05”.
Table of contents Summary of the crisis...... 3 Key issues identified: ...... 6 SECTION: Population description ...... 10 SECTION: Shelter and essential non food items...... 13 SECTION: Water supply, Sanitary and Hygiene ...... 15 SECTION: Food security and nutrition:...... 19 SECTION: Health ...... 20 Annex 1: Maps of flooded area ...... 24 Annex 2: Massive collective centres ...... 27 Annex 3: the list of urgent needs of regional Hospital of Shkodra...... 44 Annex 4: Urgent needs of Public Health Laboratory...... 49 Annex 5: Photo...... 52
Abbreviations:
DPR Disaster Planning & Response FBD Food Born Diseases IPH Institute of Public Health LRI Lower Respiratory Infections MCC Massive collective centre RDPH Regional Directorate of Public Health URI Upper Respiratory Infections VBD Vector Born Diseases WBD Water Born Diseases
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INITIAL RAPID ASSESSMENT
9-10 December 2010
Working team Name Institution Position
Ardian Xinxo WHO DPR focal point
Silva Bino IPH Chief of Infection Disease Department
Artan Ulqinaku IPH Chief of Epidemiology Sector
Valbona Bara IPH Specialist, Environmental Department Specialist, Head of Bacteriological Artan Bega IPH laboratory
Aim: To c ollect information on the health services and other fields in order to assess the current situation, identify damages in health service and basic needs requiring immediate response.
Main contacts on performing of the assessment Irena Shestani, Director, Regional Directorate of Public Health in Shkodra, Mob: 0672052590 Eridona Rusi, Vice director, Regional Directorate of Public Health in Shkodra, Mob: 0672052580 Artan Mesi, Chief of epidemiological Service, RDPH-Shkodër, Mob: 0692097523 Xhelal Kastrati, Chief of Hygiene Service, RDPH Shkoder, RDPH-Shkodër, Mob: 0672035042 Cesk Kastrati, Chief, Pumping Station, Mob: 0686086605 Besnik Kastrati, Secretary of the District Council, Member of the Emergencies Headquarter, Mob: 0692025410; Ridvan Dibra, Spokesman, Municipality of Shkodra, Mob: 0689003008; Hysen Arapi, Director, Directory of State Reserves, Ministry of Interior, Mob: 0694110741
Summary of the crisis The flooding in Shkodra has begun on the second half of November 2010 due to the heavy rains and increasing of the water drop/debouchments from the Drin cascade. The rain has continued for three days and flooding has affected ~ the national road, ~the city neighborhood: Bachallek, Livade, and ~ 4 communes: Ana- Malit, Daic, Berdice, Bushat. The flooding situation was improved within one week. On 30 of November, the flooding situation in the region of Shkodra was repeated flooding 7 communes (~Anë e Malit, ~ Dajç, ~ Velipojë, ~ Bushat, ~ Bërdicë, ~ Gur i zi, ~ Rrethinat), the suburb neighborhood of Shkodra (Baçallëk, Livade, Xhabije,
3 Perash, Salo Halili, Ahmet Haxhija, Shirok-Zogaj), and the national road (See Annex1).
On this area 14 100 hectare are flooded; 46 00 houses are surrounded by water and 2 580 are inundated; 59 604 habitant ( 5% of total population) are affected; 14 200 habitant are displacement (7 % of total population) from which 2 220 are sheltered on 6 massive collection points (5 dormitories, 1military cantonments). See annex 2; 3 712 domestic animal and poultry are drowned; 6 health center (16.2 % of the total) are flooded The national road to Shkodra is flooded making access to Shkodra difficult.
Government has declared emergency situation in the effected regions on 01/12/2010.
The overall humanity situation is good enough, and it is getting improved due to the decline of the water level on the flooded areas. Based on what the interviewer said and the factors caused the disaster, the emergent situation will last somewhat long (1-2 months). This duration will increase the level of damage in the community and will make difficult the process of the return home of the displaced population. From the displaced habitants (59 604 ) was identified only the population which has been accommodated in the massive collective centers (MCC). The location of population accommodated at the host families was not identified making difficult/impossible distribution of humanitarian aid. Part of effected population is totally isolated surrounded by water; ore has refused to be evacuated, making very difficult humanitarian actions.
The water, due to the treatment with high dose of the chlorine, is not contaminated in the water network, even 40 % of the network is still old.
Sanitary and hygiene problems/difficulties are identified at some of MCC (See annex 2). This situation in MCC of military cantonment of Renc is extremely bad and very danger from the health perspective. See annex 2.
The significant damage in the community, due to the extending of the emergency situation, is an important factors which will postpone the return home of the displaced population.
Currently, there is not any increase of the acute disease rate. The health information system ( daily and alert) which covers the health centers, the hospital emergency department and MCC enables the situation under control, enabling the quick intervention in case of any possible epidemic. The vaccination coverage of the population (including the Rome population) is very high (98%) However, extending of the emergent situation under the circumstances of a cold winter and the other factors mentioned above will increase the morbidity burden on the health system
4 The main identified shortages on the health system are related with diagnostic capacity of public health laboratory and biochemical laboratory in the regional hospital. Improvement of the shelter situation and identified needs in the MCC, the increasing of the capacities of regional hospital of Shkodra (3) are the most important factors to prevent and face the possible increasing of the morbidity under condition of an prolonge emergency situation. There are not problems related with security.
Causes of crises The climate changes in Albania reflected in Shkodra (and other districts: Lezha, Elbasan, Fushe-Kruje, Berat, Skrapar, Kucove, Tropoje) with heavy and extending rainfall causing overflow in the rivers of Buna, Drini, Kiri, and the lake of Shkodra; Serious damages in first and second water network drainage systems (maintenance, illegal construction, blockage of the river beds),
Duration of the crisis: Considering its extension and the factors that caused it, the duration is assumed to be relatively long, about a month
Factors that could worse the humanitarian conditions Incomplete evacuation of flooded population; Evacuation without preliminary information of risk population (the same area was flooded 1 week ago); Lacking of information for the population accommodated at host families; Flooding of water pumping station; Damage of electricity supply infrastructure; Flooding of road infrastructure; Flooding of water supply lines; Flooding of waste water pumping station; Discharge of the waste waters in flooded area (Shkodra lake); Blocking of the discharge of waste waters (Kuz); Over-population of massive collective centres; Serious damages of environment and property of effected population with serious impact in their economy and health; Relatively long duration of emergency situation; Winter season (wet and cold winter); Inadequate capacities in disaster planning and response;
Population groups that are isolated (difficult access) Currently, there are isolated the population of the communes of: ~Velipoja (village of Dajçi), ~Bërdic (villages of Kuç & Vukatan), ~ Guri i Zi (villages of Mali i Ushit & Ranza Bushat), ~ Rrethina (villages of Dobraç, Zeus), ~Ana e Malit, and ~ the neighbourhood of the city; Baçallëk and Xhabie are currently isolated.
This population, encircled by water, was not displaced or has refused to be evacuated.
5 Key issues identified:
Red Severe situation: urgent intervention required Key for Orange Situation of concern: surveillance required severity Yellow Lack of/unreliable data: further assessment required ranking Relatively normal situation or local population able to cope with Green crisis; no action required Key issues identified Section R O Y G Recommendations (maximum of 3 ) It is not completely To identify the identified the location of population which has evacuated population. refused to be evacuated, and population accommodated at the
host families by: group- age, gender, vulnerable groups (pregnant waman, elder population, etc) A part of the population To identify and assess is remains isolated, not emergency needs of this evacuated. population. Population In the impossibility of the evacuation and their settlement in PGM or in host families, to stabilized the channels of humanitarians aids (specific program). Affected population has Warning system should not been prepared be reviewed during /informed in advance for updating process of evacuation (preliminary regional emergency plan. notification). MCC are facing serious Provision of fuel for problems regarding heating at MCC should accommodation space be considered a priority (annex 2), and heating. and discussed with the Sites and donors or other actors.
shelter To see the possibilities to avoided the use of gas for heating and cooking at MCC. Sanitary and hygiene To discus with the infrastructure of MCC donors and civil society
(see annex 2) present agencies to reconstruct
6 serious problems. urgently the sanitary units and showers of MCC. The laundries of the The capacity of the MCC have not the right laundries with equipment capacity and furniture to and detergent should be
cover current burden. strengthen in coordination with the donors and civil society. The MCC of the Rome It should be improved population has emergent immediately the needs for all lifeline conditions of hosting services. See annex 2 regarding the space, beds, electricity, water, heating, sanitary and hygienic infrastructure.
To decrease the number of Roma population hosted in this MCC. Other solution should be taken in consideration. Lack of clothes, Needs should be evident underwear for adults and and submitted to the children donors and civil society. Essential non- Lack of cutlery and food items kitchen equipment Lack of bedclothes (linen, blankets, mattresses) and beds Lack of sanitary water in Present the problematic the MCC/ dormitory to the donators and civil Arben Broci and to the society. MCC of military corpus (Roma population) Lack of automatic To submitted the request Water supply chlorination equipments to the donor currently
for the city water invest in the region for network water infrastructure. Lack of chlorine in the To presentation the rural water supply concern to the donators,
network. especially to the UNICEF. Lack of sanitary Review the internal infrastructure in the resources to place MCC of Roma mobile sanitary units Sanitation population (The donators can contribute also in this issue).
7 Damage / lacks of Present the problematic adequate sanitary to the donators and civil infrastructure to the society. MCC caused by over population Contaminations of the Identification of the environment because of resources /activities and the discharges of the intra sector coordination waste water are flooded. to face the situation after
flood period.
Chlorination of public Hygiene environments Limited capacity of the
laundries to MCC. Present the problematic Limitations in to the donators and civil equipments and furniture society. for the personal and environmental hygiene
Food security
Nutrition
Eventual increase of Revision of current URI, LRI, WBD, FBD, contingency plan for the VBD related with cold floods related with weather, persistent of needs, capacities and Health risks emergency, life inter and intra sectorial and health conditions of affected collaboration status population after returning beck, pollution of environment, conditions offer to the MCC Vaccination of risk groups with flu vaccine Damage of health Assessment of damages facilities and coordination with Health facilities donors and social and services community to put them in function. Lack of the kits for Identification of Biochemical Laboratory resources (including of the Regional Hospital eventual donators) and Increasing regional strengthen their hospital capacities diagnostic capacities (equipments, medicine and consumable supplies
8 to face the burden related with extending emergency. Damage of the heating system in the regional hospital Limited capacities of Provision of needs by the Public Health Laboratory Institute of Public Health regarding equipments, in contact with eventual kits, and human donors (WHO, resources. UNICEF).
9 SECTION: Population description
Key informants:
Besnik Kastrati, Secretary of the District Council, Member of the Emergencies Headquarter, Mob: 0692025410 Artan Mesi, Chief of epidemiological Service, RDPH-Shkodër, Mob: 0692097523 Ridvan Dibra, Spokesman, Municipality of Shkodra, Mob: 0689003008;
Registration:
Total population of Shkodra district: 242273 Affected population: 59604, registered by the District Council referring to the data of the Civil State Office Shkodra
Evacuated population is 14 200 inhabitants. It is not expected a further increase of the evacuated population.
Size of crisis-affected population
Communes Villages Population Families Effected Dajç 11 8721 2428 7500 Ana Malit 10 5820 1551 2200 Bërdica 6 8949 2383 4475 Guri i Zi 11 11211 3035 3363 Bushat 14 23123 5925 4625 Rrethina 10 22596 5985 1130 Velipoja 10 8844 2356 2211 Municipality of Shkodra 113668 34100 Total 202932 59604
Affected population: 25% of district population Population who are not displaced: 93 % of affected population Evacuated population 7% of affected population
Groups of concern:
Children from 0-1 years: 180-200 Pregnant woman: 350 Elder: NA Roma population: 400 habitants
Main factors preventing the return home of effected population:
10 High scale of damages in the property of affected/ evacuated population; Economical factors
Affected population was settled in: Host families, and Massive Collective Centres (Dormitory, Military cantonments)
Nr. Massive Collective Centres Population accommodated 1 Dormitory ”Safet Spahiu” 257 2 Dormitory “Arben Broci” 313 3 Dormitory of Woodland school 216 4 Dormitory of University “Luigj Gurakuqi” 850 5 Dormitory “Preng Jakova” 124 6 Military cantonments 460 Total (11/12/2010) 2220
Population accommodated to MCC by age-groups
Pregnant 0-1 1-4 5-14 15-44 45-59 60+ Age-groups woman Dormitory ”Safet Spahiu” 4 5 30 59 111 21 1
Dormitory “Arben Broci” 3 14 68 131 32 65 1 Dormitory of Woodland 2 12 53 83 28 39 0 school Dormitory of University 7 43 55 267 453 25 3 “Luigj Gurakuqi” Dormitory “Preng Jakova” 0 6 4 49 56 10 0
Military cantonments 16 34 113 115 74 18 17
Total 32 114 323 704 754 178 22
% 1.5% 5.4% 15.2 33.1% 35.4% 8.4% 1.0%
Dead: 0 Missing 0 Injured: 0
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Livestock population:
Livestock effected, belonging to the effected population
Horses, Bovine Sheep/Goat Pigs Poultry Komunat donkey Drow Drow Drow Drow- Drow Total. Total Total Total Total -ned -ned -ned ned -ned Ana Malit 1488 0 1600 3 750 4 16000 480 190 0 Dajç 3260 6 3950 13 2670 13 18100 440 355 0 Velipojë 2377 3 6460 14 2270 14 15200 950 130 5 Bërdicë 2900 1 2800 19 990 2 22000 580 240 0 Bushat 7100 0 4700 3 7300 36 70000 470 830 1 Guri i Zi 2275 3 3410 1 1700 0 19550 320 185 0 Rethina 3600 0 5690 0 1410 0 113500 200 600 5 Bashkia 450 2 900 4 800 0 9000 120 20 0 Total 23450 15 29510 57 17890 69 283350 3560 2550 11
Animals and poultry drowned 1.58%
Level of damage:
Type of livestock Loss High Not high Bovine Low NA High Not high Sheep, goat Low NA High Not high Pig Low NA High Not high Poultry Low NA High Not high Horse, donkey Low NA
Comments related with livestock: The moving out of the drowned animals from flooded area (Dajç, Velipoja) still remains a problem There are not epidemics and the situation is kept under control through a daily system of information (the veterinarians of the communes report every day the epizootic situation). SECTION 3
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SECTION: Shelter and essential non food items
Key informants: Blerta Gjini; Director of dormitory, 0693867091 Vjollca Jakaj; nanny of dormitory; 0693123957 Angjelin Voci; Director of dormitory; 0672140411; Fredi Boci, Director of dormitory; 0672052070; Met Braç, accomodated citizen, 0682183130 Naim Rusta, Director of dormitory, 067 30 14 175 Fahri Beci, Director of dormitory, 069 2121 012 Rasim Smaka, Commander of Military cantonment, 069 40 13 024 Saimir Kruja, representative of Roma community, 068 56 13 805
Households currently living in massive collective centres 16% of evacuated population (2220) 3.7% of affected population (59604)
Surface of accommodation:
Surface Person m2 Nr Massive Collective Centres Accommodate of rooms per room per person m2 1 Dormitory ”Safet Spahiu” 257 12 8 1.5 2 Dormitory “Arben Broci” 313 16 10 1.6 Dormitory of Woodland 3 216 school 10 12 0.8 Dormitory of University 4 850 “Luigj Gurakuqi” 16 10 1.6 5 Dormitory “Preng Jakova” 124 16 7 2.3 6 Military cantonments 460 22 36 0.6 Total (11/12/2010) 2220
Occupation of shelters: in separate rooms (in family base) with 7-12 people per room, 79.3% (1760) in massive shelter (in family base), 20.7% (460)
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Degree o shelters to provide:
Mass shelters Separate rooms Very poor (+) Very poor; Protection from cold, Somewhat poor Somewhat poor; heat, rain, wind, etc. Acceptable; Acceptable ; (+) DN DN Very poor (+) Very poor; Minimum level of Somewhat poor Somewhat poor ; (+) privacy Acceptable; Acceptable; DN DN Very poor (+) Very poor; Personal security and Somewhat poor Somewhat poor; security of belongings Acceptable; Acceptable ; (+) DN DN
Access to essential non-food items
Clothing to ensure their dignity and protection from cold is too problematical for all the people accommodated to MCC
Cooking facilities and a sustainable source of fuel, electricity, gaze: Limited in all the PGM, while Absent in the Military cantonment
Main concerns related to shelters (infrastructure), needs: Damage of sanitary units and showers; Low capacity of the laundries with the respective equipment; Damage of water network
Main concerns related to livelihoods, hygiene, sanitary: Cooking equipments and distribution items of food (stoves and kitchenware, plates, glasses, spoon, fork, knife, etc) Clothes, underwear, clothes for children; Bedclothes (linen, blankets, mattress, etc); Food for children; Limit disinfectants; Limit detergent; Very limit personal (particularly for woman & children), environmental/rooms hygiene kits; Absent of sanitary kits; Limit fuel.
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SECTION: Water supply, Sanitary and Hygiene
Key informants: Xhelal Kastrati, Chief of Hygiene Service, DSHP Shkodra, 0672035042 Cesk Kastrati, Chief, Pumping Station, Mob: 0686086605 Blerta Gjini; Director of dormitory, 0693867091 Angjelin Voci; Director of dormitory; 0672140411; Fredi Boci, Director of dormitory; 0672052070; Naim Rusta, Director of dormitory, 067 30 14 175 Fahri Beci, Director of dormitory, 069 2121 012 Rasim Smaka, Commander of Military cantonment, 069 40 13 024
Water supply:
Institution responsible for water supply is “Water Supply and Canalization Enterprise ShA Shkodra”
Quantity by water Level of risk in the Risk of Water source sources quantity of water contamination m 3 available High risk High risk Unprotected wells NA Low risk Low risk
High risk High risk Protected wells NA Low risk Low risk
High risk High risk Water deposit m3 8000 capacity Low risk Low risk
High risk High risk Market NA Low risk Low risk
High risk High risk Network m3 3384 per hour Low risk Low risk
High risk High risk Other m3 Low risk Low risk
Limitation of capacities / effectiveness of water supply/ management system relate with: Cut off/ interruption of supply with electricity to the water supply pumping stations; Flooding of some water supply pumping stations ; Amortization of water supply network system in 40% of it; Flooding of waste/black water pumping station and contamination of environment, particularly in the quarters of the city.
Water sources of affected population:
For isolation population;
15 Market, and Aids, provided by government (state reserves), donors and different agencies of civil society.
For the MCC: Water supply network; Aids/donations with package water. With cistern vehicles; Wells; Natural resources.
Details for the water contamination risks: Amortization of water supply network in 40% of it; Mixing of the waste waters with drinking/sanitary water due to the interruption/cut off of electric supply to the water station pumps (creation of vacuum to the network); Absence of the automatic treatment with chlorine of water network; Absence of chlorine for the village water network supply system
Urgent repairs required to the water supply infrastructure: Repairing of the hygiene end sanitary infrastructure of MCC (infrastructure , equipments); Repairing of the water supply network to the MCC Dormitory Arben Broci; Repairing of treatment system with sodium to the city water supply network system. (This system is out of function)
Water network supply system for the city is regularly treated and checked for contamination.
Water treatment:
Water sources treated Places of water treatment Treatment used
Near water support Calcium Hypochlorite; Water supply network pumping stations Sodium Hypochlorite
Water treatment system function normally excluding the system of treatment with Sodium Hypochlorite in the city.
Time needed for affected population to provide drinking and sanitary water: 16-30 minutes in the city; > 60 minutes for the isolated villages, and inhabitants not yet evacuated from flooded areas
Estimated average for the quantity of water used for drinking, cooking and hygiene (litres/person/day) is >5 litres excluding: The MCC to the Military cantonments, and Flooded population refused to be evacuated
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Additional comments related to water supply: In particular, for the isolated villages and flooded population refused to be evacuated, is too difficulties to provide and treat the drinking, cooking and sanitary water; Public Health Laboratory responsible to check water contamination present shortage (Annex 4)
Sanitation:
Emergency intervention related with waste water management:
Latrines should be placed to the Military cantonments MCC where has been accommodated the Roma population; Sanitary units of the rest of MCC should be repaired (Infrastructure, equipment, hygiene furniture)
Significant presence of the vectors?
Mosquitoes Rodents Ticks Phlebotom Flies
Yes Yes Yes Yes Yes Prezence No No No No No DN DN DN DN DN
Key hygiene practices follow up by the population:
Hygiene Behaviour Before flood After flood
Never, Never, Sometimes, Sometimes, Use of toilets Always, exept Always Roma population Hand washing with soap Never, Never, Sometimes, Sometimes , after defecation Always Always Hand washing with soap Never, Never, Sometimes , Sometimes , before food preparation Always Always Hand washing with soap Never, Never, Sometimes , Sometimes , before eating Always Always Covering water in the Never, Never, Sometimes, Sometimes , household Always Always Water treatment in the Never , Never , Sometimes, Sometimes, household Always Always Never, Never, Covering food Sometimes, Sometimes , Always Always
17 Availability of resources for hygiene to the MCC:
Scarcely Widely Partially Resource available or DN available available unavailable Clean water + Suitable and accessible toilets + Suitable water containers + Anal cleansing materials + Soap + Sanitary cloths/items for women + Nappies for babies + Chlorine + Warm water +
Particular groups of communities who has difficult access to water, sanitation, hygiene facilities: Population that has refused evacuation; The isolated villages; Peoples accommodated to MCC (See annex 2).
Obstacles to attend the hygiene practices: Economic factors; Damages of hygiene and sanitary infrastructure; Isolation of flooded population; Overpopulation of MCC; Hygienic culture of specific groups as Rome population.
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SECTION: Food security and nutrition:
Information on human population NA (given of information was refused) Hysen Arapi, Director, Directory of State Reserves, Ministry of Interior, Mob: 0694110741
Livestock food situation:
Type of livestock Food availability Adequate; Bovine Not adequate; DN Adequate; Sheep, goat Not adequate; DN Adequate; Pig Not adequate; DN Adequate; Poultry Not adequate; DN Adequate; Horse, donkey Not adequate; DN
Comments: The basic needs of livestock of affected population are provided up to December 30. Resource supplier is the Government.
Concerns remain provision of food after 30 of December). Specific difficulties represent the areas isolated.
Situation was improved since the beginning of crises.
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SECTION: Health
Main informers: Namik Kamberi, Director, Regional Hospital of Shkodra, 0692024789, Irena Shestani, Director, Regional Directorate of Public Health in Shkodra, Mob: 0672052590 Eridona Rusi, Vice director, Regional Directorate of Public Health in Shkodra, Mob: 0672052580 Artan Mesi, Chief of epidemiological Service, RDPH-Shkodër, Mob: 0692097523 Xhelal Kastrati, Chief of Hygiene Service, RDPH Shkoder, RDPH-Shkodër, Mob: 0672035042 Valbona Mushtracu, First laboratory technician, Public Health Laboratory, RDPH Shkodër, Mob: 0672035041
Access to health institutions is not a concern except flooded of 7 health facilities (HF)
Flooded Health facilities:
Communs HF flooded Villages/Quarters Comments
Guri i zi 1 Kuç Has started rehabilitation Bërdic 1 Trush Has started rehabilitation Dajç 1 Dajc Flooded, out of function Bushat 1 Mali Jushit Flooded, out of function Ana Malit 1 Obot Flooded, out of function Quarter Shiroka In rehabilitation process B. Shkodër 2 HF no.: 3 In rehabilitation process
Regional Hospital:
Infrastructure A part of the hospital is under reconstruction creating difficulties to face the burden on the hospital services. Current situation does not present difficulties because morbidity has not increased significantly.
The heating system works partially. The rest of life lines don’t present any emergent concern.
The reconstruction of heating system remains a priority.
Equipments: There are shortages of equipments for Emergency and Intensive care department.
Furniture and medicine:
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At present hospital don’t have any shortage in medicaments, bur referring to the near future where expected significant increases in morbidity, the following needs are specified: Kits and reagents for biochemical laboratory; Antibiotics; IV solutions; Antipyretics
Consumable supply: Disinfectants; Personal protection equipment; Syringes; Chirurgical materials.
See annex 3: List of urgent needs of Regional Hospital
Public Health Laboratory:
Has not significant problems related with infrastructure.
Urgent needs related with equipments and furniture: Autoclave, 80 litre: 1, Refrigerator, 350 litre: 1, Working table: 1, Reagents and laboratory kits (See annex 4)
Disease control, morbidity: There is not increase in the number of visits and infection diseases
Current health situation is under control through a daily and emergency health information system which includes: health centres; hospital emergency department; paediatric ward; infective ward; health points of massive collective centres
Number of visits in hospital (02 -08/12/2010)
Dates 02. 03 04 05 06 07 08 Emergency 72 36 49 65 48 57 53 department Paediatric ward 18 22 9 11 21 15 18
21 Infective ward 1 1 1 1 1 4 1
Trend of Alert surveillance system at hospital emergency department
Dates 02. 03 04 05 06 07 08
Diarrhoea 6 5 1 5 5 11 3 Respiratory 4 9 5 0 6 2 6 Infections Measles 0 0 0 0 0 0 0
Meningitis 0 0 0 0 0 0 1
Hepatitis 0 0 0 0 0 0 0 Psychological 0 0 0 0 0 0 0 problems
Number of visits at health points of MCC
Days Massive Collective centres 02. 03 04 05 06 07 08 Dates No. of visits Dormitory ”Safet Spahiu” 18 24 46 78 40 18 15
Dormitory “Arben Broci” 20 38 35 38 40 40 36 Dormitory of Woodland 27 29 14 20 41 40 28 school Dormitory of University - - - 35 27 30 25 “Luigj Gurakuqi” Dormitory “Preng 0 3 2 1 3 6 14 Jakova” Military cantonments - - - 0 40 22 7
Total 67 97 101 177 197 163 133
22 Trend of visits at health points of mass casualty centres
250
200
150
100 no. of visits of no. 50
0 1 2 3 4 5 6 7 days
However, extending of the emergent situation for more then one month, wet and cold winter, not appropriate conditions of evacuated population, pollution and contamination of environments, and huge damages of the property of effected population, are risk factors which can increase in the near future the morbidity burden on health system in the region.
Humanitarian support There are not donations to support regional hospital.
Vaccination coverage of the region is very high (98%) including Roma population
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Annex 1: Maps of flooded area
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Flooded area in the Region of Shkodra
Flooded area of the city of Shkodra
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Annex 2: Massive collective centres
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Massive Collective Centres
No. Massive Collective Centre Accommodated population Women’s dormitory” Safet Spahiu” 257 (230) Industrial secondary school “Arben Broci” 313 Forest school dormitory 216 (217) University dormitory 850 Art school “Preng Jakova” dormitory 124 (125) “Rrenza” cantonment 460 (370) Total: 09/12/2010 2220
1 Date: 08/12/2010 Interviewees ~ Blerta Gjini, Dormitory Director, 0693867091 ~ Vjollca Jakaj, Dormitory warden, 0693123957 ~ Zana Llazani, doctor, 0692616184 ~ Eris Kaduku, Assistant epidemiologist 0672849615 Accommodation conditions: General Accommodated MGP (space/water supply, hygiene/food and food safety/health Urgent problems information population service/ medical information service/health risks/other ~8 people are accommodated in 4 bed rooms segregated by ~ Disinfectant; family ~ 24 hour uncontaminated water supply. There is also ~ Detergent; warm water. Bottle water is currently used for drinking. ~ linens (sheets, Women’s 40 rooms ~ Food is prepared in the canteen; 3 meals; good quality; no blankets, etc); dormitory” available 10-12 257 special food for children; food safety control as routinely ~ clothes, underwear Safet m2, 4 beds per practiced. in particular; Spahiu” room , ~ Common sanitary units (bathrooms); 8 bathrooms with 24 ~ fuel; hour-running water; besides the water, there are no other ~ fixing sanitary hygienic facilities in the bathrooms. units and showers;
28 ~ Premises were clean and disinfected by chlorine (halls, ~ equipment for bathrooms). cooking and ~ Central heating by a boiling room distribution of food ~ Medical centre with a 2-shift health staff (doctors and (cookers, pots, nurses). Cases occurring at night are referred to the dishes, plates, Emergency Unit at the Regional Hospital (there is an glasses, spoons and available phone number). Guaranteed, reimbursed treatment forks); according to an HII ordinance on 02/12/2010, Prot. no. ~ increase of the 2436. There is an available psychologist. Currently there are laundry capacities no particular problems/concerns (bronchitis, stress). There with the necessary are available drugs (including emergency drugs). devices; Exchange of health information with the Public Health ~ personal hygiene Directorate takes place on a daily basis and focuses on the materials/ supplies Alert System. (soap, toilette paper, Report at the end of the day. Immediate reporting for toothpaste, suspected epidemic cases. toothbrush, etc.) Note: ~ We do not think the number of the flooded families will increase. Some of them will stay long for almost 1-2 months. ~ Limited donations consisting of water, fruit juice, hygienic supplies: shampoos, toothpaste. Donator KKSh. ~ The families raise the same issues/concerns. The only changing need is baby food.
Number of visits in health facilities Days 02/12 03/12 04/12 05/12 06/12 07/12 08/12 Number of visits 18 24 46 78 40 18 15 There are no evident health problems. The epidemiological situation is under control and there are no problems. Health problems According to the Alert, the number of diagnoses has decreased (there are only IRS (30), IRP (23) and bloodless diarrhoea (3) see the respective shih email, Alert Shkolla “Safet Spahija”
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Population age groups according to Alert: gender, pregnant women 0-1 1-4 5-14 15-44 45-59 60+ Pregnant women 4 5 30 59 111 21 1
Alert daily data Trend of infectious illnesses and psychological problems in gathering centres Syndromes and illnesses Date:2 Date:3 Date:4 Date:5 Date:6 Date: 7 Date:8 Diarrhoea 0 0 0 1 1 1 0 Respiratory infections 7 2 9 11 14 3 8 Measles 0 0 0 0 0 0 0 Meningitis 0 0 0 0 0 0 0 Hepatitis 0 0 0 0 0 0 0 Psychological problems N/A N/A N/A N/A N/A N/A N/A Comments No epidemiological problems
30 2 Date: 08/12/2010 Interviewees.
~ Angjelin Voci, Dormitory director, 0672140411 ~ Suzana Bala, Doctor, 06954340 ~ Rajmonda Koçeku, Nurse, 0672046479 Accommodation conditions: General Accommodated MGP (space/water supply, hygiene/food and food safety/health Urgent problems information population service/ medical information service/health risks/other ~ Disinfectant; ~ Detergent; ~10-12 people are accommodated in 6-8- bed rooms ~ linens (sheets, segregated by family blankets, etc); ~ There is no running water. Water is supplied in tanks for ~ clothes, underwear the sanitary units (it is supplied by controlled town in particular; networks). Bottle water is currently used for cooking and ~ fuel; drinking. There is no warm water. 48 rooms ~ fixing sanitary ~ Food is prepared in the canteen; 3 meals; food safety available 16 m 2 units and showers; control as routinely practiced. Industrial 4 beds per ~ cooking and food ~ Common sanitary units (bathrooms) and showers for every secondary room, delivery equipment floor. There are hygiene and infrastructure problems (though school 5 sanitary units 313 (cookers, pots, the premises are cleaned by chlorine); there are no hygienic “Arben per floor (15) dishes, plates, facilities in the bathrooms; all boilers are dysfunctional. Broci” and 3 showers glasses, spoons and
in 3 separate forks); ~ Premises are cleaned by chlorine; settings ~ strengthening the ~ There is no heating system. There is individual heating laundry capacities system by electric or gas heaters. with the necessary ~ Health service organization as above. devices; ~ Health status: many cases of gastritis, tonsillitis, 1 ~ personal hygiene hospitalized case with bleeding diarrhoea; available drugs; it materials/ supplies is necessary to have anti-inflammatory drugs. (soap, toilette paper, toothpaste, 31 toothbrush, etc.) ~ repairing the heating system/network; Baby food; ~ devices to receive samplings from the health facility; ~ chairs, tables, kitchen counter Note: ~ We do not think the number of the flooded families will increase. ~ Limited donations consisting of soap (KKSh) soap, towels, basins (Oxfam). ~ Needs for women hygiene
Number of visits in health facilities Days 02/12 03/12 04/12 05/12 06/12 07/12 08/12 Number of visits 20 38 35 38 40 40 36 There are no evident health problems. The epidemiological situation is under control and there are no problems. Health problems According to the Alert, the number of diagnoses has decreased (there are only IRS (8), IRP (28) and bloodless diarrhoea (2) see the respective shih email, Alert Industrial School
Population age groups according to Alert: gender, pregnant women 0-1 1-4 5-14 15-44 45-59 60+ Pregnant women 3 14 68 131 32 65 1
32
Alert daily data
Trend of infectious illnesses and psychological problems in the gathering centres Syndromes and illnesses Date:2 Date:3 Date:4 Date:5 Date:6 Date: 7 Date:8 Diarrhoea 0 0 0 0 0 2 0 Respiratory infections 1 7 6 7 5 3 7 Measles 0 0 0 0 0 0 0 Meningitis 0 0 0 0 0 0 0 Hepatitis 0 0 0 0 0 0 0 Psychological problems N/A N/A N/A N/A N/A N/A N/A Comments No epidemiological problems
33 3 Date: 08/12/2010 Interviewees
~ Fredi Boci, Dormitory director, 0672052070 ~ Ahmet Kallaci, Maintenance supervisor, 0692251953 ~ Adriana Bejleri, Doctor ~ Met Braç, sheltered, 0682183130 Accommodation conditions: General Accommodated (space/water supply, hygiene/sanitary units/food and food MGP Urgent problems information population safety/health service/ medical information service/health risks/other ~12 people are accommodated in one room as segregated by ~linens (sheets, family blankets, mattresses, ~ 24 hour controlled water supply. Though the water is beds etc); germ-free, bottle water is currently used for cooking and ~ clothes, underwear drinking. in particular; ~ Food is prepared in the canteen; 3 meals; good quality; no ~ fuel for the heating special food for children; food safety control as routinely system; 15 rooms 2 practiced. ~ fixing sanitary available 22 m ~ Common sanitary units (bathrooms) and showers in every units and showers; 8-10 beds per floor. No particular problems except for shower cubicle ~ reconstruction of Forest school room, 216 doors. shower cubicles and dormitory 3 sanitary units ~ Premises are clean and disinfected by chlorine internal per floor (9) ~ Central heating by a boiling room, but there is limited fuel infrastructure; and 4 showers supply. At present, heating is individual by electric heaters. ~ personal and
~ Health service organization as above. There is 24-hour environment hygiene service. kits; ~ Health status: no serious problems. Initially there were ~ separate cases of gastritis and IRS. IRS and gastritis trends are baby/children food; expected to increase; it is necessary to have inspectorate and ~ brooms, buckets, enteritis drugs. mops, waste bins; ~ closets (lockable)
34 ~ cooking and food delivery equipment (cookers, pots, dishes, plates, glasses, spoons and forks); ~ strengthening the laundry capacities; ~ drugs Note: ~ The number of the flooded families will decrease but some will stay long (December-January) as they live around the Shkodra Lake areas. ~ Minimal donations. Donator: Oxfam, Zemra e Krishtit ~ Besides the above mentioned needs, there are also needs for women hygiene.
Number of visits in health facilities Days 02/12 03/12 04/12 05/12 06/12 07/12 08/12 Number of visits 27 29 14 20 41 40 28 Health problems IRS, Gastroenteritis. The number is expected to increase.
Population age groups according to Alert: gender, pregnant women 0-1 1-4 5-14 15-44 45-59 60+ Pregnant women 2 12 53 83 28 39 0
35
Alert daily data
Trend of infectious illnesses and psychological problems in gathering centres
Syndromes and illnesses Date:2 Date:3 Date:4 Date:5 Date:6 Date: 7 Date:8 Diarrhoea 10 0 1 1 3 1 0 Respiratory infections 18 0 0 7 2 5 6 Measles 0 0 0 0 0 0 0 Meningitis 0 0 0 0 0 0 0 Hepatitis 0 0 0 0 0 0 0 Psychological problems N/A N/A N/A N/A N/A N/A N/A Comments No epidemiological problems
36 4 Date: 09/12/2010 Interviewees
~ Naim Rusta, Dormitory director, 0673014175 ~ Xhavit Grezda, Doctor, 0692342355 Accommodation conditions: General Accommodated (space/water supply, hygiene/sanitary units/food and food MGP Urgent problems information population safety/health service/ medical information service/health risks/other ~ burning fuel for the Two 3-5-story ~8-10-12 people are accommodated in one room as boiling room;
buildings segregated by family ~ disinfectant; ~ 24 hour potable water supply, regularly checked for ~ detergent; available rooms bacteria. with an area of ~ Food is prepared in the canteen; 3 meals; good quality; no ~ linens (sheets, 16 m 2 special food for children; food safety control as routinely blankets, mattresses “Luigj 4-6 beds per practiced. etc); Gurakuqi” room, 850 ~ Common sanitary units (bathrooms) and showers are ~ clothes, underwear University 6 public working; in particular; dormitory sanitary units ~ Premises were clean and disinfected by chlorine ~ baby food and showers per ~ Central heating system, but there is limited fuel supply. ~ hygiene kits; floor The system supplies warm water, too. ~ Health service organization as above. ~ Room hygiene service for 25 ~ Health status: no serious problems. There are cases of IRS equipment (brooms, people but no diarrhoea. There were no hospitalized cases. buckets, mops, waste bins); Note: ~ Expected stay 2-3 weeks ~ Minimal donations, Donator Oxfam, KKSh distributed hygiene kits
Number of visits in health facilities Days 02/12 03/12 04/12 05/12 06/12 07/12 08/12
37 Number of visits - - - 35 27 30 25 There are IRS and IRP cases Health problems No cases with diarrhoea
Population age groups according to Alert: gender, pregnant women (*)
0-1 1-4 5-14 15-44 45-59 60+ Pregnant women
*There are various data. The number is high and the age segregated figures are not yet collected by the health staff.
Alert daily data
Trend of infectious illnesses and psychological problems in gathering centres
Syndromes and illnesses Date:2 Date:3 Date:4 Date:5 Date:6 Date: 7 Date:8 Diarrhoea 0 0 0 0 0 0 0 Respiratory infections 0 0 0 9 4 15 9 Measles 0 0 0 0 0 0 0 Meningitis 0 0 0 0 0 0 0 Hepatitis 0 0 0 0 0 0 0 Psychological problems N/A N/A N/A N/A N/A N/A N/A Comments No epidemiological problems
38 5 Date: 09/12/2010 Interviewees
~ Fahri Beci, Dormitory director, 069 2121 012 ~ Fran Kapaj, Doctor, 067 20 46 336 Accommodation conditions: General Accommodated (space/water supply, hygiene/sanitary units/food and food MGP Urgent problems information population safety/health service/ medical information service/health risks/other ~6-7 people are accommodated in one room as segregated by family ~ burning fuel for the ~ 24 hour potable water supply, regularly checked for boiling room and bacteria. warm water supply; 22 rooms ~ Food is prepared in the canteen; 3 meals; good quality; no available 16 m 2 ~ disinfectant; special food for children; food safety control as routinely 6 beds per ~ detergent; Art school practiced. room, ~ linens (sheets, “Preng 124 blankets, mattresses Jakova” ~ Common sanitary units (bathrooms) and showers are 4 public etc); dormitory working; sanitary units ~ clothes, underwear ~ Premises were clean and disinfected by chlorine and showers per children clothes in ~ 24-hour central heating system, but there is limited fuel floor particular; supply. The system supplies warm water, too. ~ Health service organization as above. ~ baby food
~ Health status: no problems. ~ hygiene kits;
Note: ~ Expected stay: 2 weeks ~ Minimal donations? Donator: KKSh, Oxfam (personal hygiene kits), Children’s Foundation, Fjala e Zotit
Number of visits in health facilities Days 02/12 03/12 04/12 05/12 06/12 07/12 08/12
39 Number of visits 0 3 2 1 3 6 14 No particular problems Health problems There are IRS cases but no diarrhoea cases. The drugs for the chronic ill are regularly received.
Population age groups according to Alert: gender, pregnant women 0-1 1-4 5-14 15-44 45-59 60+ Pregnant women 0 6 4 49 56 10 0
Alert daily data
Trend of infectious illnesses and psychological problems in gathering centres
Syndromes and illnesses Date:2 Date:3 Date:4 Date:5 Date:6 Date: 7 Date:8 Diarrhoea 0 0 0 0 1 1 0 Respiratory infections 0 0 1 0 4 15 9 Measles 0 0 0 0 0 0 0 Meningitis 0 0 0 0 0 0 0 Hepatitis 0 0 0 0 0 0 0 Psychological problems N/A N/A N/A N/A N/A N/A N/A Comments No epidemiological problems
40 6 Date: 09/12/2010 Interviewees.
~ Rasim Smaka, Commander of the “Rrenza” cantonment, 06940 13 024 ~ Ervin Troshani, Doctor, 0694249462 ~ Saimir Kruja, Roma Community representative, 068 56 13 805 Accommodation conditions: General Accommodated MGP (space/water supply, hygiene/food and food safety/health Urgent problems information population service/ medical information service/health risks/other ~ camp showers and ~6-7-11 families are accommodated (5-7 persons per sanitary units household) . (around 20); ~ Bottle water supplied by donors. Water used for cooking and sanitary purposes is supplied by a well and natural ~ drinkable and resource found contaminated by the RHD of Shkodra. sanitary water supply Roma ~ Electric power supply does not cover all premises. The from controlled resources; population infrastructure is partly damaged. There is power in only 400-460 some rooms. The office and ~ Disinfectant; ~ Individual heaters. “Rrenza” warehouse ~ hygiene kits; Shkodra ~ Food is individually prepared in the premises. There are cantonment adapted to outskirts and no cooking devices are rooms. Food is supplied by donors. ~ Room hygiene shelters other districts: ~ There are no sanitary units, besides a latrine with no equipment (brooms, Tirana, Berati, hygienic or sanitary condition. buckets, mops, waste Fushë-Kruja ~ The internal, external and personal hygiene is very bad. bins);
~ Health service organization as above. ~clothes, underwear ~ The risk groups of the Shkodra Roma community are for all age groups immunized by the anti-flu vaccine (in the January flooding these target population was immunized by one pentavalent ~cooking and food shot and Polio x 2 drops). delivery equipment
Note: ~ Expected stay: very long, until spring. Their dwellings are uninhabitable. ~ Donator: KKSh, Oxfam, UNICEF, Municipality. 41
Number of visits in health facilities: the registrations start on 05.12.2010 Days 02/12 03/12 04/12 05/12 06/12 07/12 08/12 Number of visits - - - 0 40 22 7 Health problems No particular health problems
Population age groups according to Alert: gender, pregnant women 0-1 1-4 5-14 15-44 45-59 60+ Pregnant women 16 34 113 115 74 18 17
Alert daily data Trend of infectious illnesses and psychological problems in gathering centres
Syndromes and illnesses Date:2 Date:3 Date:4 Date:5 Date:6 Date: 7 Date:8 Diarrhoea - - - 0 1 1 2 Respiratory infections 0 0 0 0 12 7 3 Measles 0 0 0 0 0 0 0 Meningitis 0 0 0 0 0 0 0 Hepatitis 0 0 0 0 0 0 0 Psychological problems N/A N/A N/A N/A N/A N/A N/A Comments No epidemiological problems
42
Main urgent problems identified in the Massive Collective Centres
Clothes and underwear for children and adults Linens (sheets, blankets, mattresses, etc.) Baby food or other children food Burning fuel for the heating systems Room hygiene equipment (brooms, buckets, mops, waste bins) Cooking and food delivery equipment Reconstruction of the sanitary units and showers infrastructure Strengthening the laundry capacities Detergents and disinfectants Continuous drug supply Providing the MGP health facilities with sampling equipment and procedures Setting up the mobile sanitary units and showers in the cantonment MGP (around 20); Continous water supply by controlled resources (“Arben Broci” dormitory and cantonment)
43
Annex 3: the list of urgent needs of regional Hospital of Shkodra
44
REPUBLIKA E SHQIPERISE SPITALI RAJONAL SHKODER Lagja « Skenderbeg », Shkoder, Albania. Tel /Fax +3552247289. E-mail [email protected]
Medicaments:
Voltaren ampul 5000 Cefataxine ampul 1000 Ciprinol ampul 2000 Ciftriaxone flakon 1000 Kemicetin ampul 5000 Flagyl 100 vl 2000 Prednisolon 5000 Marcaini 0.5 % 500 flakon Sol.Fiziollogjik 20000 Lasix amp 2000 Efortil ampul 500
Consumable Furniture
Shiringa 5cc 50000 Shiringa 10cc 70000 Betadin 500 l Alkol 96 ° 1000 l Garze 10000 m RO ˝ Filma 30x40 10.000 cope
Equipments
Defibrilator cope 2 Shiringe elektrike 4 Oximeter cope 10 Glukometer cope 4 Stripe Glicemie 2000 Aspirator cope 2 Aspirator-Pediatri 2cope Nebolizator 4 cope
45 Kits and Reagents
1.Urea 7.000 ml 2.Creatinina 2.000 ml 3.AST 2.000 ml 4.ALT 2.000 ml 5.Amilaze 2.000 ml 6.Cholesterol 5.000 ml 7.Triglicerid 5.000 ml 8.Acid uric 1.000 ml 9.Total bilirubin 1.000 ml
Per analizatorin ECHO
9.Reagent bottle for ECHO 50 cope 10.Filter for needle 100 cope 11.Clearnind solution 10 shishe 12.Needle kit 5 set 13.Lamps for ECHO 2 cope
Koagulimi.
14.PT 600 ml
Per urometer
15.Urine strip 10 parameter 2.000 cope 16.Melanzher hemoglobine 50 cope 17.Pipeta eritrosedimenti 300 cope 18.Gota urine 10.000 cope 19.Vaska Ngjyrimi 5 cope 20.ASLO Latex 50 ml 21. PCR Latex 50 ml 22.FR Latex 50 ml
Per gaz analizator ABL 50
1.Kalomel electrode 1 cope 2.PH electrode 1 cope 3.CO2 elektrode 1 cope 4.O2 elektrode 1 cope 5.Membrane CO2 1 set 6.Membrane O2 1 set 7.Sol 1 5 kuti 8.Sol 2 5 kuti 9.Sol 3 5 kuti 10.Sol 4 5 kuti 11.Sol 5 10 kuti
46 Per imunoanalizator AXSYM
1.HBsAg 1 kit 2.Rubeola IgG 1 kit 3.Rubeola IgM 1 kit 4.Toxo IgG 1 kit 5.Toxo IgM 1 kit 6.CMV 1 kit 7.Cortizol 1 kit 8.Troponin 1 kit 9.Free T3 2 kit 10.Free T4 2 kit 11.Ultra TSH 3 kit 12.Total T3 1 kit 13.Total T4 1 kit 14.Beta HCG 1 kit 15.Testosteron 1 kit 16.AFP 1 kit 17.Ca 19-9 1 kit 18.Ca 15-3 1 kit 19.Ca 125 1 kit 20.Total PSA 2 kit
47 Spitali Rajonal Shkoder
Laboratori biokimik klinik
Equipments
Sasia Cmimi ne leke
1.Autoanalizator automatic cope 1 1.000.000 2.Analizator semi automatic cope 1 400.000 3.Elektrolitmeter cope 1 350.000 4.Mikroscop biokular me immersion cope 3 60.000 5.Coagulometer cope 1 250.000 6.Fotometer cope 1 150.000 7.Gaz analizator cope 1 - 8.Cell counter cope 1 600.000
48
Annex 4: Urgent needs of Public Health Laboratory
49 Reagents, kits, equipments: Nr Emertimi I kitit dhe reagentit Njesia sasia cmimi vlera 1 Kligler iron agar kg 1 2 Endo agar kg 3 3 sabouraud agar kg 1 4 Blood agar base kg 4 5 bile salt kg 1 6 K2HPO4 kg 0.5 7 KH2PO4 kg 0.5 8 selenit broth kg 2 9 Sodium biselenit kg 0,5 10 NaOH kg 1 11 API 10S kuti 5 12 Urea agar base kg 0,5 13 Urea solution liter 0,1 14 Desoxycholate Citrate agar kg 0.5 15 Kovac`s Indole reagent ml 100 16 serum Anti salmonella polivalent OMNI O ml 5 17 serum Anti salmonella O9 ml 2 18 serum Anti salmonella O4 ml 2 19 serum Anti salmonella O2 ml 2 20 serum Anti Shigella sonnei ml 2 21 serum Anti Shigella Flexneri polyvalent ml 2 22 serum Anti Shigella Boydii C1 ml 2 23 serum Anti Shigella Boydii C2 ml 2 24 serum Anti Shigella Boydii C3 ml 2 25 serum Anti Shigella Disenteriae polyvalent ml 2 26 serum Antigen Salmonella Typhi O ml 10 27 Antigen Salmonella Typhi H ml 10 28 Antigen Salmonella paratyphi AO ml 10 29 Antigen Salmonella paratyphi HO ml 10 30 Antigen Salmonella paratyphi BO ml 10 31 Antigen Salmonella paratyphi BH ml 10 32 Antigen Salmonella paratyphi CO ml 10 33 Antigen Salmonella paratyphi CH ml 10 34 Antigen Proteus OX19 ml 10 35 Antigen brucella abortus ml 10
50
Mjete dhe pajisje 36 tampone laboratori sterile cope 2000 37 Pjata petri qelqi 100mmx12 cope 500 38 shishe 500 ml te autoklavueshem me tape cope 100 39 pompe filtri uji (100x4) cope 1 40 filtra per pompen cope 1000 41 Autokale 80Liter horizontal cope 1 42 Frigorifer 300liter cope 1 43 Klorur benzankoni liter 50
51 Annex 5: Photo
52 Flood in the Region of Shkodra, 08-10/12 / 2010
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